Provider Demographics
NPI:1184635294
Name:STEIN, DONNA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:
Last Name:STEIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2135 SENECA DR S
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-3611
Mailing Address - Country:US
Mailing Address - Phone:516-378-1619
Mailing Address - Fax:516-379-4320
Practice Address - Street 1:2135 SENECA DR S
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-3611
Practice Address - Country:US
Practice Address - Phone:516-378-1619
Practice Address - Fax:516-379-4320
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR324441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7402741OtherGHI
NY7402741OtherGHI